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Abilify tremors and akathisia


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#1 nomi

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Posted 06 October 2007 - 08:59 AM

Is Abilify known for causing akathisia and tremors even at 5mg? I would keep taking it at a low dose if I knew I'd stop feeling like all my pores are electrified and I need to run until I drop, while my hands shake uncontrollably. It does help keep paranoid, intrusive thoughts at bay, but I can't deal with these two side effects -- I just can't -- they're having a profound effect on my quality of life and my ability to do my job.

My husband thinks he understands, and maybe he does, but I'm not going to keep talking about it with him unless I have a serious need to do so. He has a hard life too, and it makes the seas a bit choppy if either one of us goes on ad nauseam about one thing. I talk about it a bit in my LJ and my 360 blog, so I do have a pressure valve where I can blow off the steam until I see my pdoc on Tuesday.

When I do see my pdoc, I'm going to present him with a list of all the things Abilify has done to me, also including muscle weakness, a mixed episode, heightened anxiety, forgetting words, and having a tiny attention span at any dose. Now that I'm at 2.5mg, I'll just see what happens over the next few days. I'm willing to keep taking it if this tiny dose is (a) helpful and (b) tolerable, but it's been so hellish that there's no chance I'll keep taking even 5mg. Does anybody even take this small a dose daily?

Thanks for listening.
Dx: BP II, GAD, fibromyalgia, migraine
Rx: Lamictal, Neurontin
Rx Graveyard: Topamax, Zoloft, Abilify, Seroquel, Cymbalta, Effexor, Wellbutrin, Pamelor


#2 Thomas

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Posted 06 October 2007 - 09:16 AM

I've been on abilfy for just two years now at 15 mg. and about four months ago, my pdoc had to start me on Cogentin because she said it was giving my diskenesia (Sp?). It has stopped the twitching and tremors most days. I can't take it until after I get to work because I can't drive very well if I take the Cogentin before I drive in. Other than that, I don't seem to be having any side-effects from the Abilify.

Tommy
Dx:BP1, OCD, Diabetetes Type 2, Hypertension, Gastroparesis & kidney stones
Rx: Abilify 20 mg., Klonopin 6.0 mg., Restoril 30 mg. Cymbalta 120 mg. , Lamictal 400 mg., Cogentin 1.5 mg. Crestor 10 mg. hydrochlorothiazide 25 mg., Hyzaar 100/25 mg., domperidone 20 mg. and Levemir Insulin 40 units, Actos 45 mg.,Proprananol ER 80 mg., Hydrocodone/APAP 40 mg./4000 mg., tizanidine 1 mg., Fiorocet 3 mg.

#3 nomi

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Posted 06 October 2007 - 09:26 AM

I've been on abilfy for just two years now at 15 mg. and about four months ago, my pdoc had to start me on Cogentin because she said it was giving my diskenesia (Sp?). It has stopped the twitching and tremors most days. I can't take it until after I get to work because I can't drive very well if I take the Cogentin before I drive in. Other than that, I don't seem to be having any side-effects from the Abilify.

Tommy


I'm also sleepy most of the time from Neurontin, Zanaflex (I can't even take a whole pill, I quarter them) and maybe Lamictal. I thought about talking to my pdoc about Cogentin after you mentioned it in another thread, but when I read that it can be sedating in some people, I wasn't so sure. But I'll ask him what he thinks. If I take one more sedating med, I won't be able to go anywhere or do anything unless I also add another med to wake me up. Grrr.

It's a shame about all this, because Abilify wrestled my paranoia into submission almost the day I started to take it, but I just cannot deal with the akathisia; it's one of the worst feelings I've ever experienced. Even now, after tapering to 2.5mg as of last night, I feel the burning all over that indicates I'm going to start getting too restless to sit still. Yeah, I guess it'll take another day or two to notice the effect of tapering.
Dx: BP II, GAD, fibromyalgia, migraine
Rx: Lamictal, Neurontin
Rx Graveyard: Topamax, Zoloft, Abilify, Seroquel, Cymbalta, Effexor, Wellbutrin, Pamelor

#4 resonance

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Posted 06 October 2007 - 10:07 AM

Have you been on any other AAPs? They may give you the same benefits without that side effect.

#5 Cetkat

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Posted 06 October 2007 - 11:14 AM

It's a shame about all this, because Abilify wrestled my paranoia into submission almost the day I started to take it, but I just cannot deal with the akathisia; it's one of the worst feelings I've ever experienced. Even now, after tapering to 2.5mg as of last night, I feel the burning all over that indicates I'm going to start getting too restless to sit still. Yeah, I guess it'll take another day or two to notice the effect of tapering.

I had the same problem with Abilify. I forget what dose I was on.. maybe 15mg? Either way I got the same akathisia, and.. yeah - there's no dealing with that unlike most side-effects. Your best bet is a beta-blocker, like the one you mentioned. (I take Nadolol)

It may or may not help, but I don't believe benzos, waiting it out, or lowering the dose works. I didn't get my Nadolol until after I went off the Abilify. So I don't know if it would have helped or not.

If it's really bothersome.. and I think it probably is - I'd try calling the pdoc and get him to call you in a beta-blocker this weekend. That way you can try it out and know by the time of your next appointment if the Abilify is something you can stay on or not.

As far as sedation goes.. I suppose it's a little drowsy, but it's not any worse than cold medicine. I don't even think it's half that bad. The only way to know for sure is to try it; but I believe a cup of coffee (or even coke) would fix the problem if you had one.


Edit: corrected a sentence

Edited by Cetkat, 06 October 2007 - 11:20 AM.

_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _

Dx: Major Depression w/ Dysthymia, Panic Disorder, GAD, ADHD, Fibromyalgia
Pdoc's Theory Dx: Bipolar NOS (MDD with BP traits w/o hypo or mania)
Rx : Emsam 12mg/24hr, Strattera 80mg, Lyrica 150mg, Armour Thyroid 120mg (2 gr), Zofran prn, Nadolol prn, Xanax prn, Methocarbamol 750mg prn, D3 4,000IU
EXRx : Zoloft, Seroquel, Wellbutrin, Prozac, Lithium, Lamictal, Remeron, Lexapro, Abilify, Zyprexa, Geodon, Cymbalta, Paxil, Sonata, Lunesta, Effexor, Metadate, Risperdal, BuSpar, Ambien, Invega, Tegretol, Nortriptyline, Desipramine, Deplin, Neurontin, Concerta, Trazodone, Mirapex, Amitriptyline, Saphris, Prestiq, Requip

I do whatever my rice krispies tell me to.
~~~~~~~~~~~~~~~~~~~
"OK so cheese is trapped, so you can't have cheese." - MDK
_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _. _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _


#6 nomi

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Posted 06 October 2007 - 01:57 PM

Have you been on any other AAPs? They may give you the same benefits without that side effect.


No, resonance, but the other one he mentioned we... er, I could try was Geodon -- or, as I like to call it, "Geodesic Dome." ;) I'm willing to try it, but I'm not sure I need an AAP as much as I need Lamictal to be increased. That's definitely something I want to talk to my pdoc about. I feel like the paranoia and racing thoughts that I think are the reason he prescribed Abilify are a result of my unstable moods. The mood swings are mostly under control because Lamictal is working pretty well, but I feel like it would work more if increased just a bit. I mean, plenty of people here are taking more than 200mg, it seems. I did have a mixed episode on Abilify, but if memory serves, there have been posts on here stating that Lamictal is not the best for mixed episodes.


It's a shame about all this, because Abilify wrestled my paranoia into submission almost the day I started to take it, but I just cannot deal with the akathisia; it's one of the worst feelings I've ever experienced. Even now, after tapering to 2.5mg as of last night, I feel the burning all over that indicates I'm going to start getting too restless to sit still. Yeah, I guess it'll take another day or two to notice the effect of tapering.

I had the same problem with Abilify. I forget what dose I was on.. maybe 15mg? Either way I got the same akathisia, and.. yeah - there's no dealing with that unlike most side-effects. Your best bet is a beta-blocker, like the one you mentioned. (I take Nadolol)

It may or may not help, but I don't believe benzos, waiting it out, or lowering the dose works. I didn't get my Nadolol until after I went off the Abilify. So I don't know if it would have helped or not.

If it's really bothersome.. and I think it probably is - I'd try calling the pdoc and get him to call you in a beta-blocker this weekend. That way you can try it out and know by the time of your next appointment if the Abilify is something you can stay on or not.

As far as sedation goes.. I suppose it's a little drowsy, but it's not any worse than cold medicine. I don't even think it's half that bad. The only way to know for sure is to try it; but I believe a cup of coffee (or even coke) would fix the problem if you had one.


Edit: corrected a sentence


The good thing is that my pdoc seems to get the message that I really am having a hard enough time on it that discontinuing might be the best option, and he's leaving that up to me for now. On the phone, he said that I could stay at 2.5mg for a while, or go back up to 5mg after a while, of just stop it altogether from 2.5mg. That last is what I think I'll end up doing, unless 2.5mg is effective and tolerable. It's such a small dose that I don't know how much good it will do.

Oh, it's bothersome, all right. Well, it seems a bit less so today, which is encouraging! If it's bad tomorrow, I might have to have him call in something just so I can work on Monday, because the last few days at work were a nightmare. I could not get comfortable with either my chair or my keyboard tray placement, so I would change every 30 seconds, it felt like. I don't have a direct number or email address for him (something I'm going to ask about), but the practice where he works has an emergency line on nights and weekends.

One thing that does help quite a bit is Benadryl. I take just one tablet, not enough to knock me out but enough to be *mildly* sedating. I notice that as soon as it starts to kick in, I don't have the electrified sensation in my pores. It makes it much easier to sit still. I think I'll just take it in the morning and have one cup of English Breakfast tea as soon as I get to work. Coffee, my beloved coffee, seems to make akathisia worse. :) Then again, if I were taking something to alleviate that, maybe one cup of coffee or one Coke wouldn't hurt.

Edited by nomi, 06 October 2007 - 01:58 PM.

Dx: BP II, GAD, fibromyalgia, migraine
Rx: Lamictal, Neurontin
Rx Graveyard: Topamax, Zoloft, Abilify, Seroquel, Cymbalta, Effexor, Wellbutrin, Pamelor

#7 papertrees

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Posted 12 October 2007 - 06:00 AM

I also got akathisia (sp?) on abilify when I first started it. It has gone away though. My main problem now are tremors, which the lamictal may have brought out. I told my pdoc about it and we'll wait 2-3 weeks to see if it subsides.

Visit my blog: Paperskyscrapers
Diagnosis: Schizoaffective, Bipolar Type; Borderline personality disorder; Anorexia nervosa
Meds: Saphris 10mg, Lamictal 200mg, Valium 10mg.


#8 Cetkat

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Posted 14 October 2007 - 08:12 AM

How is it going for you Nomi?

_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _

Dx: Major Depression w/ Dysthymia, Panic Disorder, GAD, ADHD, Fibromyalgia
Pdoc's Theory Dx: Bipolar NOS (MDD with BP traits w/o hypo or mania)
Rx : Emsam 12mg/24hr, Strattera 80mg, Lyrica 150mg, Armour Thyroid 120mg (2 gr), Zofran prn, Nadolol prn, Xanax prn, Methocarbamol 750mg prn, D3 4,000IU
EXRx : Zoloft, Seroquel, Wellbutrin, Prozac, Lithium, Lamictal, Remeron, Lexapro, Abilify, Zyprexa, Geodon, Cymbalta, Paxil, Sonata, Lunesta, Effexor, Metadate, Risperdal, BuSpar, Ambien, Invega, Tegretol, Nortriptyline, Desipramine, Deplin, Neurontin, Concerta, Trazodone, Mirapex, Amitriptyline, Saphris, Prestiq, Requip

I do whatever my rice krispies tell me to.
~~~~~~~~~~~~~~~~~~~
"OK so cheese is trapped, so you can't have cheese." - MDK
_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _. _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _


#9 nomi

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Posted 14 October 2007 - 08:37 AM

I also got akathisia (sp?) on abilify when I first started it. It has gone away though. My main problem now are tremors, which the lamictal may have brought out. I told my pdoc about it and we'll wait 2-3 weeks to see if it subsides.


I couldn't take the akathisia *and* the constant feeling of exhaustion at the same time, after giving the med a month. More power to you for sticking it out! I hope the tremor susbsides.

How is it going for you Nomi?


Thank you for asking. ;)

Well, let me just say that if my pdoc hadn't agreed to taking me off it when I saw him on Tuesday, then I would've stopped taking it anyway because it was a nightmare. He said he'd never seen anybody have as many side effects on it as me.

He gave me samples of Seroquel because I've been having trouble sleeping and my anxiety has returned with a vengeance, but he says that I can take it PRN at night only. I took it for the first time last night and I woke up twice during the night, then hit my snooze button for an hour. Hmm. I only took 25mg.
Dx: BP II, GAD, fibromyalgia, migraine
Rx: Lamictal, Neurontin
Rx Graveyard: Topamax, Zoloft, Abilify, Seroquel, Cymbalta, Effexor, Wellbutrin, Pamelor

#10 Cetkat

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Posted 15 October 2007 - 01:45 AM

Thank you for asking. :)

Well, let me just say that if my pdoc hadn't agreed to taking me off it when I saw him on Tuesday, then I would've stopped taking it anyway because it was a nightmare. He said he'd never seen anybody have as many side effects on it as me.

He gave me samples of Seroquel because I've been having trouble sleeping and my anxiety has returned with a vengeance, but he says that I can take it PRN at night only. I took it for the first time last night and I woke up twice during the night, then hit my snooze button for an hour. Hmm. I only took 25mg.

You're welcome. ;)

I'm glad that you're off of it then. I know how much it can suck. The Seroquel is a good idea.. did you hit the snooze because you were still asleep by that time? 25mg is a small dose; but this med tends to be more sedating the less you get. 50-100mg worked for me with sleep. Eventually I got used to it enough that I didn't feel hungover the next day. I wonder what caused you to wake up during the night?

What did your pdoc say about upping the Lamictal?

_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _

Dx: Major Depression w/ Dysthymia, Panic Disorder, GAD, ADHD, Fibromyalgia
Pdoc's Theory Dx: Bipolar NOS (MDD with BP traits w/o hypo or mania)
Rx : Emsam 12mg/24hr, Strattera 80mg, Lyrica 150mg, Armour Thyroid 120mg (2 gr), Zofran prn, Nadolol prn, Xanax prn, Methocarbamol 750mg prn, D3 4,000IU
EXRx : Zoloft, Seroquel, Wellbutrin, Prozac, Lithium, Lamictal, Remeron, Lexapro, Abilify, Zyprexa, Geodon, Cymbalta, Paxil, Sonata, Lunesta, Effexor, Metadate, Risperdal, BuSpar, Ambien, Invega, Tegretol, Nortriptyline, Desipramine, Deplin, Neurontin, Concerta, Trazodone, Mirapex, Amitriptyline, Saphris, Prestiq, Requip

I do whatever my rice krispies tell me to.
~~~~~~~~~~~~~~~~~~~
"OK so cheese is trapped, so you can't have cheese." - MDK
_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _. _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _


#11 nomi

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Posted 15 October 2007 - 04:58 PM

You're welcome. ;)

I'm glad that you're off of it then. I know how much it can suck. The Seroquel is a good idea.. did you hit the snooze because you were still asleep by that time? 25mg is a small dose; but this med tends to be more sedating the less you get. 50-100mg worked for me with sleep. Eventually I got used to it enough that I didn't feel hungover the next day. I wonder what caused you to wake up during the night?


I was still sleeping for about the first half hour, and then I was just not wanting to get out of bed. I guess technically it only made me hit snooze three times, then. :cussing: One thing that woke me up was my husband coming to bed. The other might have been the cats. I just thought it would help me sleep through that sort of thing, since those are things that wake me up every night. My pdoc did tell me that I could take 50mg, but that I had the option to take only 25mg if I felt more comfortable with that.

What did your pdoc say about upping the Lamictal?


He said something about wanting to let me get stabilized for about a month before we make any changes, since Abilify messed me up so much. I can see why, but right now, as I'm feeling more depressed, I'm not pleased with what I'm taking. (I think this depressed feeling could be a PMS/PMDD thing, rather than the start of an episode, but I'm so turned around right now that I can't really be sure.) It doesn't seem like he wants me to go above 200mg. When I mentioned it before, that's when he gave me Abilify, because I was talking about some serioue paranoia and I guess he though an AP would be better for that. I think it was anxiety causing the paranoia.

But anyway, I'm going to keep mentioning it to him until he says yes or no. If he says no, well, I hope he has a better idea. I tend to be more depressed or mixed than anything else. I know Lamictal's not the best for mixed episodes, but I'm not sure what would be better. Lithium? Depakote? Anyone? Bueller? :)
Dx: BP II, GAD, fibromyalgia, migraine
Rx: Lamictal, Neurontin
Rx Graveyard: Topamax, Zoloft, Abilify, Seroquel, Cymbalta, Effexor, Wellbutrin, Pamelor

#12 Cetkat

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Posted 15 October 2007 - 09:14 PM

I was still sleeping for about the first half hour, and then I was just not wanting to get out of bed. I guess technically it only made me hit snooze three times, then. :) One thing that woke me up was my husband coming to bed. The other might have been the cats. I just thought it would help me sleep through that sort of thing, since those are things that wake me up every night. My pdoc did tell me that I could take 50mg, but that I had the option to take only 25mg if I felt more comfortable with that.

Yeah, usually the Seroquel would let you sleep through that sort of thing. Although, since it's so ingrained it may take some time/dosing adjustments to get the full effect. It sounds like it didn't knock you out enough.

What did your pdoc say about upping the Lamictal?

He said something about wanting to let me get stabilized for about a month before we make any changes, since Abilify messed me up so much. I can see why, but right now, as I'm feeling more depressed, I'm not pleased with what I'm taking. (I think this depressed feeling could be a PMS/PMDD thing, rather than the start of an episode, but I'm so turned around right now that I can't really be sure.) It doesn't seem like he wants me to go above 200mg. When I mentioned it before, that's when he gave me Abilify, because I was talking about some serioue paranoia and I guess he though an AP would be better for that. I think it was anxiety causing the paranoia.

But anyway, I'm going to keep mentioning it to him until he says yes or no. If he says no, well, I hope he has a better idea. I tend to be more depressed or mixed than anything else. I know Lamictal's not the best for mixed episodes, but I'm not sure what would be better. Lithium? Depakote? Anyone? Bueller? ;)

I've had med-induced anxiety cause paranoia for me. I can see why he'd rx an AP for paranoia, but if that's the main reason, the other AP's would have made more sense for you with the anxiety factor. Depression+paranoia could be helped by Abilify, but not as much if there's an underlying cause of anxiety.. too activating. Anyway, I can understand him wanting to wait and see how the paranoia/anxiety reacts to the low dose of Seroquel - it can have an effect. (If the paranoia continues, I'd try something more calming like Risperdal if he wants to use an AP.) The depression part is another issue entirely.. IMO. AP's can have an effect on that too; but usually not at the 25-50mg level of Seroquel. It sounds like he's just dealing with the former issue and leaving the latter for your next visit.

As for what to do next, you could try a combination of Lithium and Lamictal. I've heard many people mention how stabilizing those two can be together. When you talk to him again about raising the Lamictal dose, I'd ask if he thinks adding Lithium may be a better alternative.

_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _

Dx: Major Depression w/ Dysthymia, Panic Disorder, GAD, ADHD, Fibromyalgia
Pdoc's Theory Dx: Bipolar NOS (MDD with BP traits w/o hypo or mania)
Rx : Emsam 12mg/24hr, Strattera 80mg, Lyrica 150mg, Armour Thyroid 120mg (2 gr), Zofran prn, Nadolol prn, Xanax prn, Methocarbamol 750mg prn, D3 4,000IU
EXRx : Zoloft, Seroquel, Wellbutrin, Prozac, Lithium, Lamictal, Remeron, Lexapro, Abilify, Zyprexa, Geodon, Cymbalta, Paxil, Sonata, Lunesta, Effexor, Metadate, Risperdal, BuSpar, Ambien, Invega, Tegretol, Nortriptyline, Desipramine, Deplin, Neurontin, Concerta, Trazodone, Mirapex, Amitriptyline, Saphris, Prestiq, Requip

I do whatever my rice krispies tell me to.
~~~~~~~~~~~~~~~~~~~
"OK so cheese is trapped, so you can't have cheese." - MDK
_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _. _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _


#13 nomi

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Posted 16 October 2007 - 06:19 AM

I've had med-induced anxiety cause paranoia for me. I can see why he'd rx an AP for paranoia, but if that's the main reason, the other AP's would have made more sense for you with the anxiety factor. Depression+paranoia could be helped by Abilify, but not as much if there's an underlying cause of anxiety.. too activating.


I think it was paranoia and mood swings. I remember that I said I didn't think Lamictal at 200mg was doing enough for my mood swings, and rather than increasing it, he added Abilify because I somehow gave the impression that I didn't want to increase Lamictal, or maybe because he thinks 200mg should be the highest dose. I get the impression that's what he's thinking. Meanwhile, I see people here with 500mg listed in their sigs. I don't want to go to him and say "people on a message board I belong to online are taking more than twice what I do," but I feel like I might get some resistance from him if I push for even 300mg of Lamictal. It works, it just doesn't work well enough for me at my current dose. But wow, do I ever digress. I meant to say that Abilify was supposed to become my "main med" and Lamictal was going to be the supplemental or adjunct med or however you want to put it. Well, obviously that plan didn't work...

Anyway, I can understand him wanting to wait and see how the paranoia/anxiety reacts to the low dose of Seroquel - it can have an effect. (If the paranoia continues, I'd try something more calming like Risperdal if he wants to use an AP.) The depression part is another issue entirely.. IMO. AP's can have an effect on that too; but usually not at the 25-50mg level of Seroquel. It sounds like he's just dealing with the former issue and leaving the latter for your next visit.


I don't think we'll try another AP after Seroquel, because he said that in his experience, if the patient has trouble with Abilify, then the others are likely to be even more problematic. Well, that's fine, I didn't even want to try Seroquel all that much, but I decided to give it a shot. Frankly, I won't argue if he can find something better. ;) Like I said, I feel like the anxiety is the underlying issue, beneath the paranoia, and I base that on a lifetime of anxiety that predates the paranoia. I think I need to stress that to him more on the next visit.

As for what to do next, you could try a combination of Lithium and Lamictal. I've heard many people mention how stabilizing those two can be together. When you talk to him again about raising the Lamictal dose, I'd ask if he thinks adding Lithium may be a better alternative.


I like the idea of Lithium because it's so well-known. Yeah, I know it has its own side effects, but I can't let myself worry too much about that beforehand. I'm going to mention it to him next time if things don't improve, because that's what I was hoping he might do just before he put me on Abilify. So far, I don't think I've ever suggested a med to a pdoc, just to a GP (back when we thought it was unipolar depression and I was just on ADs). I have a pretty good rapport with him, with the exception of my concern that he's too fond of the newest meds. But who could argue with as long a track record as Lithium's?
Dx: BP II, GAD, fibromyalgia, migraine
Rx: Lamictal, Neurontin
Rx Graveyard: Topamax, Zoloft, Abilify, Seroquel, Cymbalta, Effexor, Wellbutrin, Pamelor

#14 Cetkat

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Posted 16 October 2007 - 02:47 PM

I don't want to go to him and say "people on a message board I belong to online are taking more than twice what I do," but I feel like I might get some resistance from him if I push for even 300mg of Lamictal. It works, it just doesn't work well enough for me at my current dose.

Well, you wouldn't have to mention the board per se. Whenever I talk about particular meds with my pdoc, I just mention that I've heard x, y, z.. I think this or that, and ask what he thinks about it. It really doesn't matter where you get the information.. just that you have it. If you have a good pdoc, he/she will already have heard of what you're saying anyway & by mentioning it you get to see their reasoning and speak more on their level. Sometimes my pdoc has a different opinion, but we have a give & take relationship - I'll try his suggestions, and he'll try mine.

I think it was paranoia and mood swings. I remember that I said I didn't think Lamictal at 200mg was doing enough for my mood swings, and rather than increasing it, he added Abilify because I somehow gave the impression that I didn't want to increase Lamictal, or maybe because he thinks 200mg should be the highest dose. ...But wow, do I ever digress. I meant to say that Abilify was supposed to become my "main med" and Lamictal was going to be the supplemental or adjunct med or however you want to put it. Well, obviously that plan didn't work...

I don't think we'll try another AP after Seroquel, because he said that in his experience, if the patient has trouble with Abilify, then the others are likely to be even more problematic. Well, that's fine, I didn't even want to try Seroquel all that much, but I decided to give it a shot. Frankly, I won't argue if he can find something better. ;) Like I said, I feel like the anxiety is the underlying issue, beneath the paranoia, and I base that on a lifetime of anxiety that predates the paranoia. I think I need to stress that to him more on the next visit.

I think I get what you're saying.. Although changing your main med from Lamictal to Abilify (or any other AP) sounds different. Lamictal (or another mood stabilizer) is usually the main med, with others as the supplements. Or maybe it's just semantics if he was going to leave your Lamictal dose alone. However, if he wanted an AP to play that big of a role.. Seroquel isn't going to do that at the dose you're on. So it sounds like he's not really giving it a try so much as using it to get you back to baseline. I have to disagree with his opinion that Abilify determines how you'll react to other AP's. Abilify and Geodon ended up being bad for me, but Zyprexa, Seroquel, and Risperdal aren't. Also, AP's aren't really used to stop mood-swings.

That said, another anti-anxiety mood stabilizer (if it works) might be a better choice overall than a sedating AP if that's all you're dealing with. If just really depends where the paranoia is coming from. How is the Neurontin working for you?

I like the idea of Lithium because it's so well-known. Yeah, I know it has its own side effects, but I can't let myself worry too much about that beforehand. I'm going to mention it to him next time if things don't improve, because that's what I was hoping he might do just before he put me on Abilify. So far, I don't think I've ever suggested a med to a pdoc, just to a GP (back when we thought it was unipolar depression and I was just on ADs). I have a pretty good rapport with him, with the exception of my concern that he's too fond of the newest meds. But who could argue with as long a track record as Lithium's?

I think Lithium is a great med. On par with Lamictal as a good mood-stabilizer.. It also helped me alot with depression in the past, so it has that ability to raise your mood out of the depressive range. Plus, it doesn't react with the Lamictal; so you could always raise your dose and add Lithium at the same time. (A good idea since you say the Lamictal does alot.. just not enough.) You could also remain on the Seroquel if it works for you with the sleep/anxiety/paranoia. Lithium's side effects really aren't that bad. My roommate's nausea never went away, but all I was left with was the tremor.

_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _

Dx: Major Depression w/ Dysthymia, Panic Disorder, GAD, ADHD, Fibromyalgia
Pdoc's Theory Dx: Bipolar NOS (MDD with BP traits w/o hypo or mania)
Rx : Emsam 12mg/24hr, Strattera 80mg, Lyrica 150mg, Armour Thyroid 120mg (2 gr), Zofran prn, Nadolol prn, Xanax prn, Methocarbamol 750mg prn, D3 4,000IU
EXRx : Zoloft, Seroquel, Wellbutrin, Prozac, Lithium, Lamictal, Remeron, Lexapro, Abilify, Zyprexa, Geodon, Cymbalta, Paxil, Sonata, Lunesta, Effexor, Metadate, Risperdal, BuSpar, Ambien, Invega, Tegretol, Nortriptyline, Desipramine, Deplin, Neurontin, Concerta, Trazodone, Mirapex, Amitriptyline, Saphris, Prestiq, Requip

I do whatever my rice krispies tell me to.
~~~~~~~~~~~~~~~~~~~
"OK so cheese is trapped, so you can't have cheese." - MDK
_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _. _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _


#15 nomi

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Posted 16 October 2007 - 04:59 PM

Well, you wouldn't have to mention the board per se. Whenever I talk about particular meds with my pdoc, I just mention that I've heard x, y, z.. I think this or that, and ask what he thinks about it.


Good point. :)

I think I get what you're saying.. Although changing your main med from Lamictal to Abilify (or any other AP) sounds different. Lamictal (or another mood stabilizer) is usually the main med, with others as the supplements. Or maybe it's just semantics if he was going to leave your Lamictal dose alone. However, if he wanted an AP to play that big of a role.. Seroquel isn't going to do that at the dose you're on. So it sounds like he's not really giving it a try so much as using it to get you back to baseline. I have to disagree with his opinion that Abilify determines how you'll react to other AP's. Abilify and Geodon ended up being bad for me, but Zyprexa, Seroquel, and Risperdal aren't. Also, AP's aren't really used to stop mood-swings.


I didn't think Lamictal at 200mg was doing enough, so we thought we'd try Abilify as the main med, although I would've been OK if he would've increased Lamictal and maybe given me something PRN for the serious anxiety that I'm going to talk about in a couple of paragraphs. As for why the Abilify, it could be that I didn't understand exactly what all the reasons were; I was a little unglued when we talked about it. ;)

Seroquel is mainly for my insomnia and he said that if it helps any with anxiety or bipolar issues, then it's an extra benefit. He just wants me back to baseline and after a month, we'll talk about whether other changes are needed then.

That said, another anti-anxiety mood stabilizer (if it works) might be a better choice overall than a sedating AP if that's all you're dealing with. If just really depends where the paranoia is coming from. How is the Neurontin working for you?


It was working great for anxiety until I had a serious breakthrough case of extreme anxiety (I don't know how else to describe it) over Labor Day weekend, when I was alone in the house for five nights in a row. I have a serious issue with sleeping alone in the house, and over that weekend I decided stay up as late as I could, as close to dawn as possible, because it made me feel safer. Besides, I was too nervous to sleep at my usual time and I stayed up until I dropped. It left me way off balance, understandably, and by the fourth night I was a wreck: I went through the house turning on all the lights while clutching a weapon, I was convinced there were people trying to break down the door and it ended up being the cat jumping down onto the floor. Ever since then, I was on Abilify until last week, and Abilify proved to do nothing positive for my anxiety. I guess those are all extenuating circumstances so it's unfair to say how Neurontin has been working for me lately. I'm having intrusive thoughts, but overall I'm not anxious on a constant basis.

I think Lithium is a great med. On par with Lamictal as a good mood-stabilizer.. It also helped me alot with depression in the past, so it has that ability to raise your mood out of the depressive range. Plus, it doesn't react with the Lamictal; so you could always raise your dose and add Lithium at the same time. (A good idea since you say the Lamictal does alot.. just not enough.) You could also remain on the Seroquel if it works for you with the sleep/anxiety/paranoia. Lithium's side effects really aren't that bad. My roommate's nausea never went away, but all I was left with was the tremor.


Tremor would drive me up the wall, as I type all day at my job. But I guess then I'd just take meds for the tremor, if Lithium was working.

Thanks for all the suggestions and knowledge.
Dx: BP II, GAD, fibromyalgia, migraine
Rx: Lamictal, Neurontin
Rx Graveyard: Topamax, Zoloft, Abilify, Seroquel, Cymbalta, Effexor, Wellbutrin, Pamelor

#16 Cetkat

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Posted 16 October 2007 - 05:52 PM

Well, you wouldn't have to mention the board per se. Whenever I talk about particular meds with my pdoc, I just mention that I've heard x, y, z.. I think this or that, and ask what he thinks about it.

Good point. :wtf:

Yeah, it works.. I promise. ;)

I didn't think Lamictal at 200mg was doing enough, so we thought we'd try Abilify as the main med, although I would've been OK if he would've increased Lamictal and maybe given me something PRN for the serious anxiety that I'm going to talk about in a couple of paragraphs. As for why the Abilify, it could be that I didn't understand exactly what all the reasons were; I was a little unglued when we talked about it. :)

Got-ya. It was probably added mainly for that paranoia then. AP's are good for that. Personally, I would have gone for the second alternative of increasing your mood-stabilizer and adding something to boost the Neurontin benefit.

Seroquel is mainly for my insomnia and he said that if it helps any with anxiety or bipolar issues, then it's an extra benefit. He just wants me back to baseline and after a month, we'll talk about whether other changes are needed then.

Well, there ya go.. I would check and see if you're still having paranoia after two weeks and ask about increasing it to a normal dose for the next two before your appointment. That way at least you've given the Seroquel a chance, right? Might as well since you're taking it anyway..

How is the Neurontin working for you?

It was working great for anxiety until I had a serious breakthrough case of extreme anxiety (I don't know how else to describe it) over Labor Day weekend, when I was alone in the house for five nights in a row. I have a serious issue with sleeping alone in the house, and over that weekend I decided stay up as late as I could, as close to dawn as possible, because it made me feel safer. Besides, I was too nervous to sleep at my usual time and I stayed up until I dropped. It left me way off balance, understandably, and by the fourth night I was a wreck: I went through the house turning on all the lights while clutching a weapon, I was convinced there were people trying to break down the door and it ended up being the cat jumping down onto the floor. Ever since then, I was on Abilify until last week, and Abilify proved to do nothing positive for my anxiety. I guess those are all extenuating circumstances so it's unfair to say how Neurontin has been working for me lately. I'm having intrusive thoughts, but overall I'm not anxious on a constant basis.

I'd say the whole weapon ordeal is a problem.. :cussing: Again, I really don't see Abilify doing anything for paranoid anxiety (and it does sound like anxiety is a main problem here). I know Risperdal could help that.. do you think raising Neurontin could help (I'm not familiar with it's dosing..) or would adding something to augment it be the way to go? Like with the Risperdal, which helps with intrusive thoughts, or Depakote/Topamax, which I'm unsure of if they touch on that..?

I think Lithium is a great med. On par with Lamictal as a good mood-stabilizer.. Lithium's side effects really aren't that bad. My roommate's nausea never went away, but all I was left with was the tremor.

Tremor would drive me up the wall, as I type all day at my job. But I guess then I'd just take meds for the tremor, if Lithium was working.

You definitely could.. alot of people do. The beta-blockers successfully stopped my tremor, and I had it pretty bad.

_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _

Dx: Major Depression w/ Dysthymia, Panic Disorder, GAD, ADHD, Fibromyalgia
Pdoc's Theory Dx: Bipolar NOS (MDD with BP traits w/o hypo or mania)
Rx : Emsam 12mg/24hr, Strattera 80mg, Lyrica 150mg, Armour Thyroid 120mg (2 gr), Zofran prn, Nadolol prn, Xanax prn, Methocarbamol 750mg prn, D3 4,000IU
EXRx : Zoloft, Seroquel, Wellbutrin, Prozac, Lithium, Lamictal, Remeron, Lexapro, Abilify, Zyprexa, Geodon, Cymbalta, Paxil, Sonata, Lunesta, Effexor, Metadate, Risperdal, BuSpar, Ambien, Invega, Tegretol, Nortriptyline, Desipramine, Deplin, Neurontin, Concerta, Trazodone, Mirapex, Amitriptyline, Saphris, Prestiq, Requip

I do whatever my rice krispies tell me to.
~~~~~~~~~~~~~~~~~~~
"OK so cheese is trapped, so you can't have cheese." - MDK
_ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _. _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _ . _


#17 nomi

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Posted 16 October 2007 - 06:01 PM

I'd say the whole weapon ordeal is a problem.. ;) Again, I really don't see Abilify doing anything for paranoid anxiety (and it does sound like anxiety is a main problem here). I know Risperdal could help that.. do you think raising Neurontin could help (I'm not familiar with it's dosing..) or would adding something to augment it be the way to go? Like with the Risperdal, which helps with intrusive thoughts, or Depakote/Topamax, which I'm unsure of if they touch on that..?


It was the "craziest" I've felt in a long time. My husband was really worried about me, and with good reason. He would have dragged me to the pdoc's office if I hadn't already been scheduled for an appointment shortly after that incident. Fortunately, I was talking to someone at the worst of it and they helped me keep my head about me just enough. I think those coping skills I've learned in therapy helped me a lot -- hooray for therapy!

I'm still on a fairly low Neurontin dose. Crazymeds cited a study in which someone took as high as 4800mg. I'm certainly willing to try it and pdoc seems open to the idea if necessary.
Dx: BP II, GAD, fibromyalgia, migraine
Rx: Lamictal, Neurontin
Rx Graveyard: Topamax, Zoloft, Abilify, Seroquel, Cymbalta, Effexor, Wellbutrin, Pamelor

#18 Guest_Marcia_*

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Posted 13 November 2008 - 04:26 AM

Is Abilify known for causing akathisia and tremors even at 5mg? I would keep taking it at a low dose if I knew I'd stop feeling like all my pores are electrified and I need to run until I drop, while my hands shake uncontrollably. It does help keep paranoid, intrusive thoughts at bay, but I can't deal with these two side effects -- I just can't -- they're having a profound effect on my quality of life and my ability to do my job.

My husband thinks he understands, and maybe he does, but I'm not going to keep talking about it with him unless I have a serious need to do so. He has a hard life too, and it makes the seas a bit choppy if either one of us goes on ad nauseam about one thing. I talk about it a bit in my LJ and my 360 blog, so I do have a pressure valve where I can blow off the steam until I see my pdoc on Tuesday.

When I do see my pdoc, I'm going to present him with a list of all the things Abilify has done to me, also including muscle weakness, a mixed episode, heightened anxiety, forgetting words, and having a tiny attention span at any dose. Now that I'm at 2.5mg, I'll just see what happens over the next few days. I'm willing to keep taking it if this tiny dose is (a) helpful and (b) tolerable, but it's been so hellish that there's no chance I'll keep taking even 5mg. Does anybody even take this small a dose daily?

Thanks for listening.


I feel your pain. I started taking 5 mg of the Abilify, went up to 10 mg after two weeks, and was standing in church when my left arm started shaking. Went to the ER and they said it was more than likely from the abilify. I wont touch the stuff ever again. Scared the living hell out of me.

#19 Guest_T_*

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Posted 27 August 2009 - 12:25 PM

Is Abilify known for causing akathisia and tremors even at 5mg? I would keep taking it at a low dose if I knew I'd stop feeling like all my pores are electrified and I need to run until I drop, while my hands shake uncontrollably. It does help keep paranoid, intrusive thoughts at bay, but I can't deal with these two side effects -- I just can't -- they're having a profound effect on my quality of life and my ability to do my job.

My husband thinks he understands, and maybe he does, but I'm not going to keep talking about it with him unless I have a serious need to do so. He has a hard life too, and it makes the seas a bit choppy if either one of us goes on ad nauseam about one thing. I talk about it a bit in my LJ and my 360 blog, so I do have a pressure valve where I can blow off the steam until I see my pdoc on Tuesday.

When I do see my pdoc, I'm going to present him with a list of all the things Abilify has done to me, also including muscle weakness, a mixed episode, heightened anxiety, forgetting words, and having a tiny attention span at any dose. Now that I'm at 2.5mg, I'll just see what happens over the next few days. I'm willing to keep taking it if this tiny dose is (a) helpful and (b) tolerable, but it's been so hellish that there's no chance I'll keep taking even 5mg. Does anybody even take this small a dose daily?

Thanks for listening.



#20 Guest_bally_*

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Posted 04 June 2010 - 08:33 AM

Is Abilify known for causing akathisia and tremors even at 5mg? I would keep taking it at a low dose if I knew I'd stop feeling like all my pores are electrified and I need to run until I drop, while my hands shake uncontrollably. It does help keep paranoid, intrusive thoughts at bay, but I can't deal with these two side effects -- I just can't -- they're having a profound effect on my quality of life and my ability to do my job.

My husband thinks he understands, and maybe he does, but I'm not going to keep talking about it with him unless I have a serious need to do so. He has a hard life too, and it makes the seas a bit choppy if either one of us goes on ad nauseam about one thing. I talk about it a bit in my LJ and my 360 blog, so I do have a pressure valve where I can blow off the steam until I see my pdoc on Tuesday.

When I do see my pdoc, I'm going to present him with a list of all the things Abilify has done to me, also including muscle weakness, a mixed episode, heightened anxiety, forgetting words, and having a tiny attention span at any dose. Now that I'm at 2.5mg, I'll just see what happens over the next few days. I'm willing to keep taking it if this tiny dose is (a) helpful and (b) tolerable, but it's been so hellish that there's no chance I'll keep taking even 5mg. Does anybody even take this small a dose daily?

Thanks for listening.







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